Breast Lumps: Types, Monitoring, and Key Concerns

Breast lump

I have been monitoring a breast cyst annually.
Today, I went for an ultrasound examination at the breast surgery department, and the doctor did not mention the cyst but noted a 0.7 cm mass.
When I asked if it was an adenoma, the doctor said that based on its shape and size, it did not appear to be concerning and advised me to continue monitoring.
I would like to ask: 1.
What types of breast masses are there? I often see cysts and fibroadenomas online; what should I be aware of? 2.
Should the follow-up be changed to every six months or remain annually? 3.
If the doctor did not suggest a needle biopsy, is it unnecessary? 4.
What is the difference between a cyst and a mass? I am quite worried and would appreciate any help and advice from the doctor.
Thank you.

Aa, 30~39 year old female. Ask Date: 2022/12/02

Dr. Tang Yuxiong reply Surgery

Common breast tumor, fibroadenoma, presents as a high echogenicity on ultrasound due to glandular hyperplasia.
If a short-term follow-up over six months shows growth from 1.0 cm to 1.3 cm, which is an increase of over 30%, minimally invasive surgical excision is recommended.
If there is no change, a follow-up ultrasound in 6 to 12 months is sufficient.
Fibrocystic changes are not tumors; they result from ductal dilation and fluid accumulation, primarily influenced by individual constitution and female hormones, with 99% being benign.
General practitioners consider the risk to be less than 2% and mostly recommend observation.
Even with fine needle aspiration, there is a 20% false negative rate, so if there are concerns regarding the cyst, minimally invasive surgical excision may be considered.

Reply Date: 2022/12/02

More Info

Understanding breast lumps can be a source of anxiety for many individuals, especially when faced with new findings during routine screenings. It’s important to clarify the types of breast lumps, the monitoring process, and the key concerns associated with them.

1. Types of Breast Lumps: Breast lumps can generally be categorized into two main types: cysts and solid masses. Cysts are fluid-filled sacs that are usually benign and can vary in size. They often fluctuate with the menstrual cycle and may cause discomfort. On the other hand, solid masses can include a variety of conditions, such as fibroadenomas (benign tumors made up of glandular and connective tissue), phyllodes tumors, and in some cases, malignant tumors (breast cancer). The distinction between these types is crucial, as it influences the management and follow-up strategies.

2. Monitoring Frequency: The frequency of follow-up examinations depends on the characteristics of the lump and the recommendations from your healthcare provider. If the lump is small (like the 0.7 cm mass you mentioned) and appears benign based on imaging studies, your doctor may recommend monitoring it with follow-up ultrasounds every 6 to 12 months. If there are any changes in size, shape, or if new symptoms develop, more frequent monitoring or further evaluation may be warranted.

3. Need for Biopsy: A biopsy is typically recommended if there are concerning features on imaging studies or if the lump changes in appearance or symptoms. If your doctor did not suggest a needle biopsy, it may indicate that they do not have significant concerns about the lump at this time. However, if you have persistent worries or if the lump changes, you should feel empowered to discuss this with your doctor and ask for a biopsy or further evaluation.

4. Difference Between Cysts and Tumors: The primary difference between cysts and tumors lies in their composition. Cysts are fluid-filled and generally benign, while tumors can be solid masses that may be benign or malignant. Cysts can often be aspirated (drained) if they cause discomfort, while tumors may require further investigation to determine their nature.
In your case, since the doctor mentioned that the shape and size of the lump do not appear concerning, it is a positive sign. However, it is essential to stay vigilant and maintain regular follow-ups. If you experience any new symptoms, such as changes in the lump, pain, or discharge, you should contact your healthcare provider promptly.

Lastly, it’s completely normal to feel anxious about breast health, especially when new findings arise. Consider discussing your concerns with your healthcare provider, who can provide reassurance and clarify any uncertainties. Regular self-examinations and awareness of your breast health are also important. If you notice any changes, don’t hesitate to seek medical advice. Remember, early detection and proactive management are key components of breast health.

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